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Skin picking disorder is characterized by repetitive excoriation of one’s skin. Although skin picking disorder is associated with substance use problems, no previous research has examined the associations of alcohol use on skin picking symptomatology.
Methods
Adults with skin picking disorder (n = 182) were recruited from the general community via an online survey. Participants completed the Alcohol Use Disorders Identification Test (AUDIT) to measure alcohol use and various self-report measures to assess clinical profiles and associated characteristics. We compared variables of interest between those with hazardous alcohol use in the past year (AUDIT ≥8) compared to those with low-risk or no alcohol use in the past year. We also examined the extent to which skin picking disorder symptoms were dimensionally related to AUDIT scores while controlling for confounders.
Results
Of the 182 adults with skin picking disorder, 62 (34.1%) met criteria for hazardous alcohol use. Hazardous drinking was associated with less frequent skin picking but higher overall picking-related severity and impairment, aggression, and rates of comorbid borderline personality disorder, gambling disorder, and compulsive sexual behavior disorder. Skin picking-related impairment predicted the degree of hazardous drinking while controlling for sex.
Conclusions
This study highlights the importance of screening for hazardous alcohol use in people with skin picking disorder. More research is needed to explore the relationship between aggression, hazardous alcohol use, and skin picking, as well as how treatments might best be adapted to treat individuals with this cluster of symptoms.
Digital oratory skills have become essential for academic and professional success in today’s digital world, making it imperative to integrate digital oratory training into public speaking pedagogy. This study examined second language (L2) speakers’ public speaking anxiety and nonverbal speech performance in the context of digital oratory. Participants were 40 English as a second language students enrolled in a public speaking course at a Hong Kong university. Each student recorded and uploaded an 8-minute speech to a digital learning platform. They also completed a questionnaire measuring digital oratory anxiety and participated in semi-structured interviews sharing their perceptions of digital presentation. Nonverbal speech performance was assessed, and correlations with digital oratory anxiety were analyzed. The results showed that cognitive and physiological factors had a greater influence on digital oratory anxiety than behavioral and technical factors. Although no significant correlations were found between digital oratory anxiety and nonverbal speech performances, the technical factor had the least impact on L2 students’ anxiety, leading to positive outcomes regarding the technical quality of the speech videos. Comparatively, eye contact and gestures attained much lower mean scores than voice control and facial expressions. Interview results further elucidated the benefits and challenges students experienced during digital presentations. Pedagogically, the findings highlight the need of a holistic approach considering cognitive, physiological, behavioral, and technical factors to address L2 learners’ digital oratory anxiety. Given its affordability and accessibility, digital oratory can be effectively integrated into instruction to develop L2 students’ multimodal communication and nonverbal delivery skills.
On April 28, 2025, a large-scale blackout affected mainland Spain and Portugal for over ten hours, severely impacting Emergency Medical Services (EMS). Although the cause remains uncertain and initially cyberattack was a concern, it has most probably been related to infrastructure failure. This event exposed critical vulnerabilities in EMS preparedness, as no region had a specific contingency plan for power outages.
The blackout led to wide-spread disruption, including traffic signal failures that caused accidents and delayed emergency response, and the collapse of communication networks that affected 1-1-2 emergency calls. Fuel shortages also emerged as gas stations became non-operational. Patients using home medical devices faced life-threatening situations, with at least one death reported due to a ventilator failure. The reliance on technology proved to be a major weakness, as many EMS systems lacked backup communication tools like satellite phones or analog radios, and many hospitals and ambulance bases were not prepared with stable generators and adequate fuel access.
Coordination between EMS, hospitals, and other emergency services was challenged by incompatible protocols and equipment. Despite these difficulties, EMS demonstrated adaptability by prioritizing urgent care and reallocating resources. The event exposed systemic fragilities and underscored the need for robust emergency planning, interagency drills, technological redundancy, and investment in resilient infrastructure. This incident serves as a global wake-up call, emphasizing that health systems must be prepared for increasing risks from climate change, cyber threats, and energy insecurity. Emergency preparedness should shift from being reactive to proactive, focusing on flexible systems, coordinated action, and workforce training to ensure continuity of health care during future blackouts.
This study aimed to assess the prevalence of post-COVID syndrome (PCS) and identify associated risk factors among healthcare workers (HCWs) in a large tertiary care hospital, with the objective of highlighting the importance of preparedness for similar post-viral syndromes in future pandemics.
Background:
Post-COVID syndrome, a form of post-viral syndrome, encompasses a range of long-term symptoms affecting multiple organ systems, which can persist after the recovery from COVID-19.
Methods:
A cross-sectional study was conducted using an online self-administered survey among HCWs who tested positive for COVID-19 at a large tertiary medical centre in Beirut.
Findings:
Among the 134 participants who had experienced COVID-19, nearly half (47.7%) reported symptoms consistent with PCS. Fatigue, shortness of breath, poor memory, and poor concentration were the most frequently reported symptoms, lasting for over three months post-COVID-19 infection in the majority of patients. Direct care of COVID-19 patients and higher severity of acute COVID-19 infection were significantly associated with an increased likelihood of developing PCS. Further research to enhance understanding and management of post-viral syndromes is needed. Additionally, proactive strategies should be implemented to mitigate associated risks in healthcare settings, emphasizing the importance of preparedness for future pandemics.
Heat-transfer measurements published in the literature seem to be contradictory, some showing a transition for the dependance of the Nusselt number (${\textit{Nu}}$) with the Rayleigh number (${\textit{Ra}}$) behaviour at ${\textit{Ra}} \approx 10^{11}$, some showing a delayed transition at higher ${\textit{Ra}}$, or no transition at all. The physical origin of this discrepancy remains elusive, but is hypothesised to be a signature of the multiple possible flow configurations for a given set of control parameters, as well as the sub-critical nature of the transition to the ultimate regime (Roche 2020 New J. Phys. vol. 22, 073056; Lohse & Shishkina 2023 Phys. Today vol. 76, no. 11, 26–32). New experimental and numerical heat-flux and velocity measurements, both reaching ${\textit{Ra}}$ up to $10^{12}$, are reported for a wide range of operating conditions, with either smooth boundaries, or mixed smooth–rough boundaries. Experiments are run in water at $40\,^\circ \textrm {C}$ (Prandtl number, ${\textit{Pr}}$ is 4.4), or fluorocarbon at $40\,^\circ \textrm {C}$ (${\textit{Pr}}$ is 12), and aspect ratios 1 or 2. Numerical simulations implement the Boussinesq equations in a closed rectangular cavity with a Prandtl number 4.4, close to the experimental set-up, also with smooth boundaries, or mixed smooth–rough boundaries. In the new measurements in the rough part of the cell, the Nusselt number is compatible with a ${\textit{Ra}}^{1/2}$ scaling (with logarithmic corrections), hinting at a purely inertial regime. In contrast to the ${\textit{Nu}}$ vs ${\textit{Ra}}$ relationship, we evidence that these seemingly different regimes can be reconciled: the heat flux, expressed as the flux Rayleigh number, ${\textit{Ra}}\textit{Nu}$, recovers a universal scaling with Reynolds number, which collapses all data, both our own and those in the literature, once a universal critical Reynolds number is exceeded. This universal collapse can be related to the universal dissipation anomaly, observed in many turbulent flows (Dubrulle 2019 J. Fluid Mech. vol. 867, no. P1, 1).
Taylor Swift has dreamt of two things: fame and success, and a quiet life with someone she loves. She dreams of making it and of escaping it. The problem is that these dreams seem to conflict. Achieving one can feel like giving up on the other. Swift’s new album, The Life of a Showgirl, finds both dreams well represented. She wants immortality and a basketball hoop in the driveway. She also has a new insight for reconciling them. Happiness can be made, she tells us. And if you make it with another person, you might be able to live two dreams that once felt impossible to fit together.
This Element synthesizes a decade of research on who is doing what and where in global value chains. Moving beyond the traditional product- or industry-based approach, the authors introduce a task-based framework for analyzing trade and structural transformation. This novel perspective captures the increasingly fragmented and specialized nature of global production. They present new data and methods to measure the income and employment associated with task exports, and analyze evolving patterns of task specialization along countries' development paths. By demonstrating the versatility and policy relevance of this approach, they aim to inspire further research and inform debates on trade, growth, and development. This title is also available as open access on Cambridge Core.
The Sustainable Development Goal for Health and Well-being (SDG#3) faces major challenges in reaching its 2030 targets, largely due to funding gaps. The pandemic has further strained fragile health infrastructure, reversing progress in life expectancy and maternal mortality reduction. Traditional funding – government spending and aid – falls short of demand.
This chapter explores game-changing solutions to unlock health capital for the Global South, revealing why private investment – common in energy and infrastructure – remains underutilized in health. It examines how blended finance, impact investing, remittances, and corporate ESG capital can transform funding. With real-world examples, it illustrates how catalytic finance can bridge shortfalls and offers a roadmap for policymakers, investors, and changemakers to rethink health finance and mobilize toward a healthier, more equitable world.
Language deficits are frequently described by patients with multiple sclerosis (MS); however, objective characterization remains somewhat limited due to its omission from standard MS cognitive evaluation and the inconsistent findings that arise from current language measures.
Objective:
To establish alternative approaches to characterizing single-word level language in MS, this study (i) validates the Sydney Language Battery (SYDBAT) visual confrontation naming subtest and (ii) examines the insights provided by examining naming errors and latencies.
Methods:
40 MS patients from Royal Melbourne Hospital’s Cognitive Neuroimmunology Clinic and 40 matched controls completed a series of neuropsychological tests, including the SYDBAT and ‘gold standard’ confrontation naming task, the Boston Naming Test (BNT). Error types and latencies on the SYDBAT were extracted from assessment audio recordings.
Results:
SYDBAT and BNT scores were highly correlated (r = 0.81, p < .001) and these tasks reported comparable receiver operating characteristic curves (p = .091). Latency analysis captured lexical retrieval difficulties, with patients displaying significantly longer mean latencies than controls on the SYDBAT (p = .012, β = 0.54).
Conclusions:
These findings support the validity of the SYDBAT and value of the latency analysis in characterizing language impairment in MS. Use of the SYDBAT and latency considerations contribute to a broader assessment with a briefer administration time compared to gold-standard evaluation. The study thereby offers clinicians an enhanced toolkit to more effectively and appropriately evaluate language functioning and supplement standard cognitive evaluation in this population.
The Pelagatos volcano is situated within the Sierra Chichinautzin Volcanic Field (SCVF), 20 km southeast of Mexico City. Previous radiocarbon (14C) dating has revealed that the age of the Pelagatos volcano ranges from 2.5 ± 0.1 to 14.1 ± 0.2 ka BP (1σ). The analysis of additional cosmogenic radionuclides, such as in situ 10Be, facilitates the confirmation of the geochronology of any geological phenomenon by determining exposure ages in quartz minerals. This study proposes a new chronology for the exposure of the Pelagatos volcano rocks by in situ analysis of 10Be in olivine samples collected from five locations. The average 10Be ages in olivine from Pelagatos rocks range from 3.95 ± 0.97 ka to 5.7 ± 1.4 ka (1σ), with a mean age of 4.6 ± 0.9 ka and 4.9 ± 0.9 ka for flow 1 and flow 2, respectively. These results are consistent with previously reported 14C ages, confirming the reliability of the 10Be exposure ages obtained in this study. The in situ dating of 10Be in olivine minerals presents a viable alternative for elucidating the volcanic history and estimating the timing of the next eruption in this volcanic field.
The study of the Indigenous peoples of Mexico and Central America during the colonial era has long been a central pillar in the historiography of Latin America. This essay, a contribution to the TAM Vault series, provides an overview of colonial Mesoamerican ethnohistory through a quantitative and qualitative study of relevant articles and book reviews published in The Americas. My primary goal in writing this essay is to demonstrate how increased attention to Indigenous-language sources, beginning in the 1990s, has transformed the writing of colonial history in Mexico and Central America. By tracking data from relevant publications and analyzing the debates and discussions featured in the journal, I construct a chronological historiography of colonial Mesoamerican ethnohistory from 1944 through 2019.
Health technology assessment (HTA) has become an integral part of Ukraine’s health system since its formal introduction into national legislation in 2017. By 2020, HTA was mandated for evaluating publicly funded medicines, laying the groundwork for more evidence-based healthcare decisions. Although the creation of an independent HTA agency was initially planned for 2022, implementation was delayed due to the COVID-19 pandemic and Russia’s ongoing invasion. The relevant Cabinet Resolution calls for the establishment of an autonomous agency by January 2026. This commentary outlines a strategic, evidence-informed framework to guide the agency’s formation.
Methods
Drawing on the 2018 State Strategy for Access to Medicines, the 2022 Law on Medicinal Products, and international best practices, we proposed to the Government of Ukraine a two-tier structure encompassing core business functions (HTA and appraisal, guideline development, pricing, and listing) and support business functions (data and analytics, finance and strategy, IT, human resources, legal, and communications). Each department is tasked with clear mandates and supported by performance indicators to promote transparency, accountability, and operational efficiency.
Results
A phased roadmap for 2025–2027 details the legal, institutional, and financial steps required for successful implementation. Key opportunities – including international partnerships and system-wide reform – are weighed alongside risks such as funding uncertainty, workforce limitations, and geopolitical instability.
Conclusion
By embedding HTA into national policy processes and ensuring institutional independence, Ukraine can enhance the value of healthcare investments and build long-term resilience into its health system.
This concluding chapter elaborates on the main themes that have run through this book. It argues for the unity of knowledge in the natural sciences, the arts and humanities, and the hard and soft social sciences (section 1); discusses eclecticism and experimentalism as a compelling intellectual response to navigating the risk-uncertainty conundrum (section 2); illustrates different forms of coping with the risk-uncertainty conundrum with the help of punditry, scenarios, and forecasts (section 3); draws out the implications of the complementarity of risk and uncertainty for moral luck, policy, and pragmatism (section 4); and, returning to worldviews, points to the affinities that science and religion share in our coping with the risk-uncertainty conundrum (section 5).
Second-order beliefs – what political actors think others think – can shape agenda-setting and even shift public opinion. Because of the collective-action nature of mitigating human-caused climate change, such second-order political beliefs are particularly important to study. Through an innovative survey design focusing on a policy proposal to introduce meat-free days in canteens, we present the first simultaneous comparison of ordinary citizens’, locally elected political representatives’, and centrally employed public administrators’ own opinions and their ability to accurately identify the majority position of citizens. While citizens are split in their opinion on meat-free days in canteens, a clear majority of unelected elites support it, and most elected elites do not support this policy. Nonetheless, we find that all three groups tend to underestimate the level of policy support among citizens. Through rigorous analysis, we show that elected elites are significantly more likely to underestimate public support for a meat-free day compared to citizens and unelected elites. These results provide important insights into the dynamics of democratic governance and suggest that underestimation of citizens’ support for climate policies may further complicate an already challenging policy area.
We study a continuous-time mutually catalytic branching model on the $\mathbb{Z}^{d}$. The model describes the behavior of two different populations of particles, performing random walk on the lattice in the presence of branching, that is, each particle dies at a certain rate and is replaced by a random number of offspring. The branching rate of a particle in one population is proportional to the number of particles of another population at the same site. We study the long time behavior for this model, in particular, coexistence and noncoexistence of two populations in the long run. Finally, we construct a sequence of renormalized processes and use duality techniques to investigate its limiting behavior.